Entrapped Dilator in a Male-to-Female Transgender Patient: Tips and Tricks for Device Removal

Medical cases involving foreign bodies can present unique challenges, especially when they occur in sensitive areas, such as the neovagina of a male-to-female transgender.

A 32-year-old transgender woman attended a tertiary, academic-affiliated hospital and reported to insert a vaginal dilator into the neovagina after removing its base and after mild abdominal pain and difficulty in removing the dilator after multiple successful attempts, she looked for help in the emergency room.

A video article demonstrates a step-by-step approach to remove the device. Under intravenous anesthesia, a neovaginoscopy was performed using a saline solution for dilation with a Bettocchi Hysteroscopy Set, equipped with a 4 mm and 30º scope, ultimately revealing the absence of fistulas or perforations. Hydrodistension probably played a major role to reduce difficulty to remove the dilator, as this was clamped with Pozzi forceps after 800 ml of infusion. Urogenital fistulas or rupture of the neovaginal vault was excluded after careful revision. Patient was discharged on the same day with a prescription for antibiotics.

Neovaginoscopy with an important hydrodistention proved to be a method for locating and removing the entrapped dilator.